human rights and legislation who resource book on mental health

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16.4 Employment Legislation could include provisions for the protection of persons with mental disorders from discrimination <strong>and</strong> exploitation in employment <strong>and</strong> equal employment opportunities. It could also promote reintegration into the workplace for people <strong>who</strong> have experienced a mental disorder, <strong>and</strong> ensure protection from dismissal from work solely on account of mental disorder. Legislation could also promote “reasonable accommodation” within the workplace, whereby employees with mental disorders are to be provided with a degree of flexibility in their working hours in order to be able to seek mental health treatment. For example, an employee could take time off to receive counselling <strong>and</strong> make up for that time later in the day. The Rio Negro (Argentina) Act for the Promotion of Health Care <strong>and</strong> Social Services for Persons with Mental Illness (Act 2440, 1989) states that “the province shall ensure that appropriate measures to ensure access to work, which is a decisive factor in the recovery of persons with mental illness, are taken”. It further decrees that a commission be established to examine the issue of work promotion, which will propose appropriate permanent measures to guarantee access to work for persons covered by the Act. Laws can also contain provisions for establishing adequate funding of vocational rehabilitation programmes, provisions for preferential financing for income-generating activities by people with mental disorders residing in the community, <strong>and</strong> general affirmative action programmes to improve access to jobs <strong>and</strong> paid employment. Employment <strong>legislation</strong> can also provide protection to persons with mental disorders working in sheltered work schemes to ensure they are remunerated at a comparable rate to others <strong>and</strong> that there is no forced or coercive labour in such sheltered schemes. Employment <strong>legislation</strong> that incorporates provisions concerning maternity leave, especially paid maternity leave, has proved effective as a health promotion tool in many countries. It allows new mothers to spend more time with their infants <strong>and</strong> facilitates the establishment of affective bonds, thus promoting good mental health for both infant <strong>and</strong> mother. 16.5 Social security The payment of disability grants can represent a huge benefit for people with mental disorders, <strong>and</strong> should be encouraged through <strong>legislation</strong>. Where pensions are provided, disability pensions for persons with mental disorders should be paid at a similar rate as pensions granted to persons with physical disabilities. The social security <strong>legislation</strong> needs to be flexible enough to allow people with mental disorders to get back into employment, especially part-time employment, without losing the benefits of their disability pension. 16.6 Civil issues Persons with mental disorders have the right to exercise all civil, political, economic, social <strong>and</strong> cultural <strong>rights</strong> as recognized in the Universal Declaration of Human Rights, The International Covenant on Economic, Social <strong>and</strong> Cultural Rights, <strong>and</strong> the International Covenant on Civil <strong>and</strong> Political Rights. Some of the key <strong>rights</strong> (often denied to people with mental disorders) that need to be protected are mentioned below. This is not an exhaustive list; it merely illustrates the wide range of <strong>rights</strong> that may need to be protected. However, some of these <strong>rights</strong> are subject to limitations based on a person’s capacity at a given point in time. • Right to vote • Right to marry • Right to have children <strong>and</strong> to maintain parental <strong>rights</strong> • Right to own property 82
• Right to work <strong>and</strong> employment • Right to education • Right to freedom of movement <strong>and</strong> choice of residence • Right to health • Right to a fair trial <strong>and</strong> due process of law • Right to sign cheques <strong>and</strong> engage in other financial transactions • Right to religious freedom <strong>and</strong> practice Additional substantive provisions relating to mental health: Key issues There are a number of important areas of mental well-being that can be effectively legislated but which have been neglected historically. These include the following: • Legislation should protect people with mental disorders from discrimination. • People with mental disorders may need legislative protection in their interaction with the general health care system, including access to treatment, quality of treatment offered, confidentiality, consent to treatment <strong>and</strong> access to information. • Legislation can incorporate provisions for giving persons with mental disorders priority in State housing schemes <strong>and</strong> those granting subsidized housing. • Legislation can m<strong>and</strong>ate governments to establish a range of housing facilities such as halfway homes <strong>and</strong> long-stay, supported homes. • Legislation can include provisions for the protection of people with mental disorders from discrimination <strong>and</strong> exploitation in employment <strong>and</strong> equal employment opportunities. • Legislation can promote “reasonable accommodation” for employees with mental disorders, by providing them with a degree of flexibility in working hours, to enable them to seek mental health treatment. • Employment <strong>legislation</strong> can provide protection to persons with mental disorders <strong>who</strong> are employed in sheltered work schemes to ensure that they are remunerated at a comparable rate to others, <strong>and</strong> that there is no forced or coercive labour in such sheltered schemes. • Where pensions are provided, disability pensions for persons with mental disorders should be paid at a similar rate as pensions granted to persons with physical disabilities. • People with mental disorders should retain the right to vote, to marry, to have children, to own property, to work <strong>and</strong> employment, to education, to freedom of movement <strong>and</strong> choice of residence, to health, to a fair trial <strong>and</strong> due process of law, to sign cheques <strong>and</strong> engage in other financial transactions, <strong>and</strong> to religious freedom <strong>and</strong> practice. 17. Protections for vulnerable groups – minors, women, minorities <strong>and</strong> refugees The need for specific <strong>legislation</strong> for minors, women, minorities <strong>and</strong> refugees affected by mental disorders would probably be unnecessary if practice showed that these vulnerable groups received adequate <strong>and</strong> nondiscriminatory treatment <strong>and</strong> services. However, in reality these groups are discriminated against <strong>and</strong> serious inequities do exist. The extent <strong>and</strong> form of these problems vary from country to country, <strong>and</strong> the specific issues that different countries need to address through <strong>legislation</strong> also differ. Nonetheless, no country is immune to discrimination against vulnerable groups, <strong>and</strong> thus some aspects of the following sections will be relevant for all countries. 17.1 Minors Legislation protecting the <strong>human</strong> <strong>rights</strong> of children <strong>and</strong> adolescents should take account of their particular vulnerabilities. It should specifically aim to respect, protect <strong>and</strong> fulfil their <strong>rights</strong>, as laid out in the UN Convention on the Rights of the Child (1990) <strong>and</strong> other relevant international instruments. In many countries there are no specialized mental health services for minors, <strong>and</strong> <strong>legislation</strong> can therefore play an important role in promoting the establishment of <strong>and</strong> access to such services. 83
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WHO RESOURCE BOOK ON MENTAL HEALTH,
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All rights reserve
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Technical contribution and<
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Nacanieli Goneyali Maria Grazia Gia
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Leen Meulenbergs Harry I. Minas Alb
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Harvey Whiteford Ray G. Xerri XIE B
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5. Rights of users of mental health
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4.1.3 Sanction, promulgation <stron
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For whom is this R
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This chapter covers five main areas
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3.2 Violations of human</st
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3.5 Promoting access to mental heal
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health legislation
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The right to health, as embodied in
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trade, torture and
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The MI Principles have also served
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8.4 The Salamanca Statement <strong
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Chapter 2 Content of mental health
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persons with mental disorders. The
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Mental disability is not synonymous
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Mental Disability Mental Incapacity
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Definition of “mental ill health
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Example: Mental health in primary c
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Page 51 and 52: MI Principles: Access to informatio
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Page 57 and 58: mentally ill offender. Countries ma
Page 59 and 60: 7.3 Determining incapacity
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Page 67 and 68: “separate” process from admissi
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Page 71 and 72: as an inpatient or outpatient. This
Page 73 and 74: Example: Successful appeal of an ad
Page 75 and 76: 8.3.7 Involuntary treatment in comm
Page 77 and 78: Figure 1. Procedure for combined in
Page 79 and 80: Emergency situations: Key issues
Page 81 and 82: 10.1 Major medical and</str
Page 83 and 84: MI Principles: Seclusion an
Page 85 and 86: The MI Principles and</stro
Page 87 and 88: Authorize or prohibit intrusive <st
Page 89 and 90: • confidentiality • independent
Page 91 and 92: 14.2 Responding to calls for assist
Page 93 and 94: 15. Legislative provisions relating
Page 95 and 96: For minor offences, the court could
Page 97 and 98: 15.4 The post-sentencing (serving s
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Page 103 and 104: In countries where women are detain
Page 105: Kenya The Mental Health Act (Act No
Page 108 and 109: Figure 2. Process of mental health
Page 110 and 111: ) Qualitative information from focu
Page 112 and 113: When examining another country’s
Page 114 and 115: • The process of building a conse
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Page 122 and 123: 4.1.2 Debate of draft legis
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Page 126 and 127: Example: The National Commission ta
Page 128 and 129: 5.2.4 Developing information <stron
Page 130 and 131: Human resource iss
Page 132 and 133: Rosenthal E, Sundram C (2002). Inte
Page 134 and 135: Declaration of Hawaii (1983). Appro
Page 136 and 137: Bibliography Araya R et al. (2001).
Page 138 and 139: Introduction and h
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Page 142 and 143: C. Access to mental health care 1)
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) there is serious likelihood of ha
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• Patient lacks the capacity to m
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2) Are all the criteria and
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O. Special treatments 1) Does the l
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3) Does the law specify a restricte
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R. Oversight and r
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3) (iv) Maintain registers of accre
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• the right of patients a
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3) Does the law allow for people <s
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2) Does the law provide for “reas
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3) Does the law ensure that all min
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AZ. Offences and p
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• Inter-American Convention on th
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Civil and Politica
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5. A patient shall never be invited
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Principle 15 Admission principles 1
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Principle 20 Criminal offenders 1.
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Annex 5. Extract from the Declarati
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5. Organ Transplantation: The role
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Restraint & Seclusion: If condition
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Rights of Recipients Summary in Eng
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PART C TAKING PERSON TO APPROVED ME
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I base my opinion on the following
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Annex 9. Example: New Zeala
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Who can make an advance directive?
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